Medicare Part B Only

Apr 21, 2017

  1. lifeismylife76
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    Hello. I am new to Medicare and have been selling Dual Special Needs plans in KS. I signed up a gentleman the other day whose red white and blue card said "Part B Only" on it. My manager was perplexed, she has sold over 500 apps and never seen that. I went ahead and submitted the app, with full knowledge it may not get approved. But, I did some googling and it just doesn't make sense. I have signed up 20 year olds with Part A and B. Clearly, they did not work 10 quarters. Anyone else run across this?

    Thanks!:1cool:
     
  2. yogooglethis
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    I just had a DSNP case that could explain this.Client didn't have the 10 quarters for free part A so when they were told at the SS office they would have to pay 400.00 for part A they declined it.What the SS office failed to tell the client was that the Medicare Savings program would pay for the Part A-as well as part B
     
  3. Northeast Agent
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    Is that depending on what state it is? I'm in PA and just looked at the MSP guidelines and it doesn't say that about Part A. I think some states have different guidelines.

    I also looked at the Four Types of Medicare Savings Programs and only QMB and QDWI pay for Part A, but it doesn't mention anything about them not having worked enough to be eligible.
     
  4. midwestbroker
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    I have run into this, mainly with immigrants. If they do not have 10 years under their belt to qualify for Medicare Part A and they are dual, Medicaid will pay first for hospitalizations and then Part B pays for the usual, with Medicaid picking up the remaining costs.

    I think the logic here is why would Medicaid pay for Part A when they can just simply pay hospitalization bills as they come and not have the monthly expense of Part A. I am sure there is an actuary out there that has ran the numbers and said do it that way. But I have been wrong a time or two in my life...LOL
     
  5. TwoCents
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    Is the question just about not having Part A or are you trying to tie it into the Medicaid piece as well? Another reason for not having Part A is simply not paying into Medicare (you see this with government jobs). They receive the coverage in a different way (that is through a pension/retiree plan). Can it hurt their options down the road? Sure, but that's the way it goes.
     
    TwoCents, Apr 21, 2017
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  6. yogooglethis
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    Although the income limits may vary by state anybody that qualifies for QMB or higher medicaid will have their part A and B paid for.I have run in to many cases where the client has been on disability for along time but never enrolled in medicare because someone either at the medicaid office of SS office told them they would have to pay the part A and B premium because of lack of quarters without explaining to them that if they have qmb that this will be paid by the MSP.

    The catch is that the beneficiary has to take a leap of faith here and enroll in medicare a and b before they see something in writing that it will be paid by the MSP

    https://www.dcf.state.fl.us/programs/access/docs/esspolicymanual/a_09.pdf



    for Pa. PA DHS - Medical Assistance for Older People and People with Disabilities



    Qualified Medicare Beneficiary (QMB) - Categorically Needy Program

    Also referred to as Healthy Horizons in Pennsylvania, individuals who qualify for these benefits are eligible for Medical Assistance payment of their Medicare Part A and Part B premiums and payment of Medicare deductibles and coinsurance. They are also eligible for medical coverage through the Medical Assistance program. Income and resource limits are as follows:
     
  7. DeadSlash
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    I didn't read all of the responses, so I apologize if this is already covered:

    There is a sliding scale based on age, so a 20 year old can get it without 10 quarters. That's how they got it.

    This is my 8th year doing Medicare and I've seen it a handful of times. It isn't common, but it isn't unheard of. Most likely the person did not qualify for premium free part A and simply couldn't afford it. It's quite pricey, depending on how many quarters you worked, it could be over $400 a month.
     
  8. jdeasy
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    You need a new manager. It's not a common thing to find someone with only part B but it's not all that unusual either.

    The person may be on Medicaid and they take care of the bills. But they will not be able to get a Medicare Advantage plan without A and B.
     
    jdeasy, Apr 22, 2017
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  9. yorkriver1
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    I just saw my first one of those last month. Newer to the country, low income, not enough quarters for Medicare. Medicaid pays for what Part B doesn't. What JD said about no MAPD, must have A & B.
     
  10. bill3173
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    Isn't it a law that a full dual eligible would have their Part A premium paid by Medicaid? I think there is some miscommunication on this point, even by the people responsible for getting this info. to the bene. I'm working on a case now, that it appears that the client was not properly informed, and is not enrolled in Part A, believing that she has to pay the premium.

    However, the only part b only that I've had in the past were people whose incomes were too high for Medicaid, and they elected not to pay the part A.
     
    Last edited: Mar 14, 2019 at 3:36 PM
    bill3173, Mar 14, 2019 at 3:29 PM
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